Mezey Gillian, Rowe Renarta, Adshead Gwen
St George's, University of London, UK.
South West London and St George's Mental Health NHS Trust, UK.
BJPsych Bull. 2021 Jun;45(3):183-189. doi: 10.1192/bjb.2020.96.
To explore the experiences and support needs of consultant forensic psychiatrists, whose patients had committed homicide while under their care. We circulated a survey to all forensic psychiatrists in the UK, through the Royal College of Psychiatrists, asking about their experiences of a homicide by a patient under their care. Respondents were invited to discuss their experiences further in a structured telephone interview and themes were identified from these discussions. Data were analysed quantitatively and qualitatively.
One-third of the 86 respondents had had at least one patient who had committed a homicide while under their care. Of these, over three-quarters (78%) reported that the homicide had a significant impact on their personal life, professional life and/or mental/physical health. For some respondents, the impact was severe and long term. Respondents generally felt that they would have been helped by receiving more support in the aftermath of the homicide.
Greater recognition is needed of the impact on treating psychiatrists of homicide by a patient and more support is needed for affected clinicians. Further research is necessary, including the effects of such events on colleagues in other specialties and examination of the costs versus the benefits of mandatory inquiries after homicides.
探讨法医精神科顾问医生的经历及支持需求，这些医生的患者在其照护期间实施了杀人行为。我们通过皇家精神病学院向英国所有法医精神科医生发放了一项调查问卷，询问他们对照护下患者杀人情况的经历。受邀受访者通过结构化电话访谈进一步讨论他们的经历，并从这些讨论中确定主题。对数据进行了定量和定性分析。
86名受访者中有三分之一至少有一名患者在其照护期间实施了杀人行为。其中，超过四分之三（78%）的人报告称，该杀人事件对他们的个人生活、职业生活和/或身心健康产生了重大影响。对一些受访者来说，这种影响是严重且长期的。受访者普遍认为，在杀人事件发生后若能得到更多支持，他们会从中受益。
需要更加认识到患者杀人行为对主治精神科医生的影响，且需要为受影响的临床医生提供更多支持。有必要进行进一步研究，包括此类事件对其他专科同事的影响，以及对杀人事件后进行强制性调查的成本效益分析。
